Follow-Up Deemed Lacking for People Taking Opioids

WEDNESDAY March 9, 2011 -- Though opioid painkillers, such as oxycodone, can lead to addiction and overdose, people who take them are frequently not tracked by the primary care doctors who prescribed the drugs, a new study has found.

"Our study highlights a missed opportunity for identifying and reducing misuse of prescribed opioids in primary care settings," the study's lead author, Dr. Joanna Starrels, an assistant professor of medicine at Albert Einstein College of Medicine in New York, said in a college news release.

"The finding that doctors did not increase precautions for patients at highest risk for opioid misuse should be a call for a standardized approach to monitoring," Starrels said.

The researchers studied the records of more than 1,600 people who took prescription opioids for chronic pain for an average of two years.

Ideally, such patients would have regular urine drug tests, make regular visits to their doctors' offices and not get many prescription refills early on.

However, the study found that only 8 percent of patients overall, and 24 percent of those considered high-risk for abuse, underwent drug testing, and only half made regular visits to their doctors. People at higher risk were more likely to get frequent refills early on.

"We were disturbed to find that patients with a drug use disorder were seen less frequently in the office and were prescribed more early refills than patients without these disorders," Starrels said. "We hope that these findings will call attention to this important safety concern."

The researchers recommend that doctors create guidelines for treatment of all patients who take opioid painkillers, require regular face-to-face office visits so that patients can be examined and follow refill schedules that are set and agreed upon at the start.

The study was published online March 2 in the Journal of General Internal Medicine.

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